“Pull Yourself Together”: Trauma and Sensory Integration Issues

 

Our bodies have 5 senses and 7 sensory data inputs:

1.Sight

2. Smell

3. Hearing

4. Taste

5. Touch

6. Balance

7. Body Position

All of our senses organize information from inside and outside our body and communicate the “data” to the brain. This organization allows us to know where our body is in time and space, to feel safe in one’s own body, and to perceive our body’s relationship to others and the environment.

A child who has experienced trauma typically has a dysintegration of sensory information that will result in a dysregulation of thinking and emotion. They will not be aware of where their bodies are in time and space, cannot feel safe in their own body, and are unable to make connections to others and the environment.

Stressful sensory input is handled by the lower levels of the brain (brain stem and limbic system) and the body and overseen by the higher, executive level of the brain. If the stressful input is mild, normal coordination between all levels of the brain and the body coordinate smoothly. If the stress is high and overwhelming, the lower levels will “hijack” the higher levels to protect the body. This is called the “fight or flight” reaction to perceived danger. If these two mechanisms are not able to bring the body back into a place of safety, the brain will react by “freezing” or shutting down.

The fight, flight and freeze reactions are designed to allow the higher order areas of the brain to continue operating so that is appears that traumatized children are functioning in some areas of life but there will continue to be gross areas of dysfunction in development. This will manifest in “gaps” between a child’s age and stage of development. They may be 15 years of age chronologically but act like a 5 year old socially and emotionally. Parenting strategies will have to adjust to meet both the 5 year old and the 15 year to close the gap.

Sensory “confusion” will drive traumatized children to be sensory seekers and/or sensory defenders. Sensory seekers look a lot like children diagnosed with attentional deficits. They appear impulsive, can’t sit still, wiggle a lot, touch things, put things in their mouths, tear things apart, easily distracted, etc. These are attempts to get more information about themselves and the world around them. Sensory defenders are quickly overwhelmed by certain sensory information in one or more of the sensory systems: visual, auditory, kinesthetic, oral, and olfactory. They will complain about the brightness of lights, the hum of electric motors, dislike loud noises, be irritated by the feel of clothing on their skins, be picky eaters, sensitive to perfumes and candles, etc. Children can have combinations of both sensory seeking and sensory defending.

There are 4 treatment strategies to help traumatized children with sensory integration issues:

1. Awareness

2. Adaption

3. Exposure

4. Advocacy

Awareness allows parents and children to be aware of their sensory triggers and needs. Adaption provides assistance to the child to get the sensory information they need or takes steps to avoid sensory overload. Exposure, in small increments over time, helps children build tolerance and increase functioning. Advocacy requests support from the child’s academic and social environment so that teachers and friends understand the issues and incorporate adaptations as well.

Sensory Integration: Shaping Perceptions of the World A newly emerging therapy for alcohol- and drug-exposed children

parentingtoolbox:

By Ira Chasnoff, MD

One of the relatively new common themes emerging in clinical care and research with children exposed to alcohol and drugs during pregnancy is related to deficits in sensory integration. Jean Ayres, an occupational therapist, first introduced the concept of sensory integration – the process by which the brain receives, organizes and interprets information from the environment. The information is received by sensory receptors, such as the eyes, nose, ears, fingers, mouth and skin. Sensations such as movement, body awareness, touch, sight, sound and the pull of gravity make up the overall sensory experience.

Source: https://www.psychologytoday.com/blog/aristotles-child/201405/sensory-integration-shaping-perceptions-the-world

The information that is received from the environment is then sent to the corresponding regions of the brain where it is interpreted and organized. Proper sensory integration helps us to maintain attention and build positive relationships with others and shapes our perception of the world. In children, sensory integration provides a crucial foundation for more complex learning and behavior. All of these things contribute to positive self-esteem as well as the ability to learn and concentrate.

For most children, sensory integration develops in the course of ordinary childhood activities. However, prenatal alcohol or drug exposure or lack of stimulation in the early years of development can damage the parts of the brain responsible for sensory integration. An infant who is neglected or has limited opportunities for human interaction, movement, play and exploration is likely to develop sensory integration problems. Sensory integration dysfunction can result when babies are unable to explore their surroundings, are left alone in their cribs for long periods of time, and do not receive the nurturing touch of a caretaker. Likewise, these problems can occur in children who have been hospitalized early or for long periods of time, or in those who have suffered from some sort of trauma and disruption in their developmental process. These life factors are not uncommon in children born into a home in which substance abuse and violence are integral components of the environment.

Children who are experiencing sensory integration difficulties are not intentionally misbehaving. They are simply trying to gain the input that their body needs or avoid extra stimulation in order to function properly. Children with sensory processing problems often feel uncomfortable in their own skin, agitated or out of sorts. That is why it is not uncommon for the children to receive a diagnosis of attention deficit hyperactivity disorder (ADHD) as they reach school age. These children are often intelligent but struggle to control their body and their need for sensory inputs. It is important to remember that the sensory needs of these children are just that – needs. Trying to diminish the needs for these behaviors will not be effective, but finding adaptable ways to satisfy the sensory needs of the child is helpful.

It is important that assessment of sensory integration capabilities be evaluated in children with prenatal alcohol or drug exposure. Some signs that a child may be experiencing difficulty with sensory integration include:

• Clumsy behaviors

• Over sensitivity to sounds, sights, smell, touch or movement

• Under reactivity to sounds, sights, smell, touch or movement

• Distractibility

• Hard to calm down

• Difficulty during transitions and adapting to changes in routine

• Picky when eating – particularly sensitive to the texture or feel of foods

• Resistant to touching things – e.g., resists going barefoot in the grass, playing in sand

• Defensive to light touch

• Agitation when spinning or roughhousing

• Excessive seeking out of spinning or swinging movements

• Tendency to exhibit rocking or swaying body movements

• Increased excitation during play to the point that he cannot calm down

• Distractibility when eating in a noisy environment

• Easily tired

• Weakness in various muscles

• Fear or intolerance of sounds – e.g., holds hands over ears to protect himself from sounds

• Awareness of noises that others do not notice

• Difficulties with teeth brushing, hair washing and/or bathing

• Sensitivities to clothing textures and/or needs tags cut out of clothing

• Overly fearful or avoidant of situations or people

• Impulsivity or exhibiting “daredevil” behaviors

• Difficulty falling or staying asleep.

Of course, many of these difficulties fall into the range of normal behavior, but it is when they cluster or are more frequent and more disruptive than what would be normally expected that they may indicate significant problems.

An occupational therapist, trained in sensory integration assessment and treatment, can evaluate a child and provide these services. Children with prenatal alcohol or drug exposure often suffer early neglect and trauma; sensory integration is a very helpful approach from both perspectives. It often is quite amazing to see the improvement in children’s daily behavior and functioning when they receive this specialized form of treatment.

Note from Ron Huxley: “I posted this some time ago on this blog but thought it timely, for me, to reblog it. I am teaching a class today on Parenting The Drug Exposed Child. Hope it helps others too…”

Sensory Integration: Shaping Perceptions of the World A newly emerging therapy for alcohol- and drug-exposed children

By Ira Chasnoff, MD

One of the relatively new common themes emerging in clinical care and research with children exposed to alcohol and drugs during pregnancy is related to deficits in sensory integration. Jean Ayres, an occupational therapist, first introduced the concept of sensory integration – the process by which the brain receives, organizes and interprets information from the environment. The information is received by sensory receptors, such as the eyes, nose, ears, fingers, mouth and skin. Sensations such as movement, body awareness, touch, sight, sound and the pull of gravity make up the overall sensory experience.

Source: https://www.psychologytoday.com/blog/aristotles-child/201405/sensory-integration-shaping-perceptions-the-world

The information that is received from the environment is then sent to the corresponding regions of the brain where it is interpreted and organized. Proper sensory integration helps us to maintain attention and build positive relationships with others and shapes our perception of the world. In children, sensory integration provides a crucial foundation for more complex learning and behavior. All of these things contribute to positive self-esteem as well as the ability to learn and concentrate.

For most children, sensory integration develops in the course of ordinary childhood activities. However, prenatal alcohol or drug exposure or lack of stimulation in the early years of development can damage the parts of the brain responsible for sensory integration. An infant who is neglected or has limited opportunities for human interaction, movement, play and exploration is likely to develop sensory integration problems. Sensory integration dysfunction can result when babies are unable to explore their surroundings, are left alone in their cribs for long periods of time, and do not receive the nurturing touch of a caretaker. Likewise, these problems can occur in children who have been hospitalized early or for long periods of time, or in those who have suffered from some sort of trauma and disruption in their developmental process. These life factors are not uncommon in children born into a home in which substance abuse and violence are integral components of the environment.

Children who are experiencing sensory integration difficulties are not intentionally misbehaving. They are simply trying to gain the input that their body needs or avoid extra stimulation in order to function properly. Children with sensory processing problems often feel uncomfortable in their own skin, agitated or out of sorts. That is why it is not uncommon for the children to receive a diagnosis of attention deficit hyperactivity disorder (ADHD) as they reach school age. These children are often intelligent but struggle to control their body and their need for sensory inputs. It is important to remember that the sensory needs of these children are just that – needs. Trying to diminish the needs for these behaviors will not be effective, but finding adaptable ways to satisfy the sensory needs of the child is helpful.

It is important that assessment of sensory integration capabilities be evaluated in children with prenatal alcohol or drug exposure. Some signs that a child may be experiencing difficulty with sensory integration include:

• Clumsy behaviors

• Over sensitivity to sounds, sights, smell, touch or movement

• Under reactivity to sounds, sights, smell, touch or movement

• Distractibility

• Hard to calm down

• Difficulty during transitions and adapting to changes in routine

• Picky when eating – particularly sensitive to the texture or feel of foods

• Resistant to touching things – e.g., resists going barefoot in the grass, playing in sand

• Defensive to light touch

• Agitation when spinning or roughhousing

• Excessive seeking out of spinning or swinging movements

• Tendency to exhibit rocking or swaying body movements

• Increased excitation during play to the point that he cannot calm down

• Distractibility when eating in a noisy environment

• Easily tired

• Weakness in various muscles

• Fear or intolerance of sounds – e.g., holds hands over ears to protect himself from sounds

• Awareness of noises that others do not notice

• Difficulties with teeth brushing, hair washing and/or bathing

• Sensitivities to clothing textures and/or needs tags cut out of clothing

• Overly fearful or avoidant of situations or people

• Impulsivity or exhibiting “daredevil” behaviors

• Difficulty falling or staying asleep.

Of course, many of these difficulties fall into the range of normal behavior, but it is when they cluster or are more frequent and more disruptive than what would be normally expected that they may indicate significant problems.

An occupational therapist, trained in sensory integration assessment and treatment, can evaluate a child and provide these services. Children with prenatal alcohol or drug exposure often suffer early neglect and trauma; sensory integration is a very helpful approach from both perspectives. It often is quite amazing to see the improvement in children’s daily behavior and functioning when they receive this specialized form of treatment.

Four Steps for Working With Trauma: An Interview with Bessel van der Kolk

Step 1: Start with Self-Regulation

Dr. van der Kolk: I would say the foundation of all effective treatments involves some way for people to learn that they can change their arousal system.

Before any talking, it’s important to notice that if you get upset, taking 60 breaths, focusing on the out breaths, can calm your brain right down. Attempting some acupressure points or going for a walk can be very calming.

Dr. Buczynski: So this is learning to modulate arousal?

Dr. van der Kolk: Yes, and there’s alarmingly little in our mainstream culture to teach that. For example, this was something that kindergarten teachers used to teach, but once you enter the first grade, this whole notion that you can actually make yourself feel calm seems to disappear.

Now, there’s this kind of post-alcoholic culture where if you feel bad, you pop something into your mouth to make the feeling go away.

“The issue of self-regulation needs to become front and center in the treatment of trauma.”
It’s interesting that right now there are about six to ten million people in America who practice yoga, which is sort of a bizarre thing to do – to stand on one foot and bend yourself up into a pretzel. Why do people do that? They’ve discovered that there’s something they can do to regulate their internal systems.

So the issue of self-regulation needs to become front and center in the treatment of traumatized people. That’s step number one.

Step 2: Help Your Patients Take Steps Toward Self-Empowerment

The core idea here is that I am not a victim of what happens. I can do things to change my own thoughts, which is very contrary to the medical system where, if you can’t stand something, you can take a pill and make it go away.

The core of trauma treatment is something is happening to you that you interpret as being frightening, and you can change the sensation by moving, breathing, tapping, and touching (or not touching). You can use any of these processes.

It’s more than tolerating feelings and sensations. Actually, it is more about knowing that you, to some degree, are in charge of your own physiological system.

There needs to be a considerable emphasis on “cultivating in myself,” not only as a therapist, but also as a patient – this knowing that you can actually calm yourself down by talking or through one of these other processes.

So, step number two is the cultivation of being able to take effective action. Many traumatized people have been very helpless; they’ve been unable to move. They feel paralyzed, sit in front of the television, and they don’t do anything.

“Programs with physical impact would be very, very effective treatments.”
Programs with physical impact, like model mugging (a form of self-defense training), martial arts or kickboxing, or an activity that requires a range of physical effort where you actually learn to defend yourself, stand up for yourself, and feel power in your body, would be very, very effective treatments. Basically, they reinstate a sense that your organism is not a helpless (tool) of fate.

Step 3: Help Your Patients Learn to Express Their Inner Experience

The third thing I would talk about is learning to know what you know and feel what you feel. And that’s where psychotherapy comes in: finding the language for internal experience.

The function of language is to tie us together; the function of language is communication. Without being able to communicate, you’re locked up inside of yourself.

“Without being able to communicate, you’re locked up inside of yourself.”
So, learning to communicate and finding words for your internal states would be very helpful in terms of normalizing ourselves – accepting and making (the communication of internal states) a part of ourselves and part of the community. That’s the third part.

Step 4: Integrate the Senses Through Rhythm

We’re physical animals, and to some level, we’re always dancing with each other. Our communication is as much through head nodding and smiles and frowns and moving as anything else. Kids, in particular, and adults, who as kids were victims of physical abuse and neglect, lose those interpersonal rhythms.

“Rhythmical interaction to establish internal sensory integration is an important piece.”
So, some sort of rhythmical interaction to establish internal sensory integration is an important piece that we are working on. With kids, we work with sensory integration techniques like having them jump on trampolines and covering them with heavy blankets to have them feel how their bodies relate to the environment because that’s an area that gets very disturbed by trauma, neglect, and abuse, especially in kids.

For adults, I think we’ve resolved rhythmical issues with experiences like tango dancing, Qi Gong, drumming – any of these put one organism in rhythm with other organisms and is a way of overcoming this frozen sense of separation that traumatized people have with others.

Dr. Buczynski: These are four keystones that can make healing from trauma faster and more effective. In order to give patients the best chance for recovery, consider these steps as you plan your interventions and treatments.

– See more at: http://www.nicabm.com/bessel-van-der-kolk/confirmed/?del=7.8.15BesselLMtoall#sthash.tU3FljBE.dpuf